Form St-4-X - Amended Metropolitan Pier And Exposition Authority Food And Beverage Tax Return - 2001
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Illinois Department of Revenue
ST-4-X
Amended Metropolitan Pier
and Exposition Authority Food
and Beverage Tax Return
REV 01 FORM 038
E S _____/_____/_____
NS
DP
CA
RC
Do not write above this line.
Read this information first
Everyone should complete Parts 1, 2, and 5.
You must also complete
Amount you are paying: $ _________________
• Part 3 if you believe you have overpaid; and
Make your check payable to “Illinois Department of Revenue.”
• Part 4 if you are changing financial information.
Part 1: Identify your business
“X” only if address is different from the address on your
1
IBT no. _____________________________________________
original return, and complete Item 4 below.
Illinois business tax number
2
4
Liability period being amended
__________________________
Mailing address ______________________________________
Number and street
3
Business name _______________________________________
_______________________________________________________
City
State
ZIP
Part 2: Check the reason you are correcting your return
1
3
_____
I took a deduction on my original return that was not
_____
I put an amount on the wrong line on either Form ST-4
allowed or was too large.
or Form ST-7.
2
_____
I should have taken a deduction or a larger deduction
4
on my original return because I sold food and beverages
_____
I overcollected the MPEA Food and Beverage Tax
from my customer.
a
_____
to another Illinois business for resale.
5
(Business’ IBT no. ___________________)
_____
I made a computational error.
b
_____
to an out-of-state customer, and the sale was
6
in interstate commerce. The merchandise
_____
The original IBT number was incorrect. The correct IBT
was delivered to a location outside Illinois.
number is ____________________________________.
c
_____
to an exempt organization.
7
(Tax-exempt no. E- ___________________)
_____
The original liability period was incorrect. The correct
d
_____
that were returned by my customer.
liability period is _______________________________.
e
_____
for another reason. (Please explain.)
8
____________________________________
_____
Other. (Please explain.) __________________________
____________________________________
_____________________________________________
____________________________________
_____________________________________________
____________________________________
_____________________________________________
____________________________________
_____________________________________________
Part 3: If you are claiming an overpayment, you must answer the following questions
1
Did you collect the overpaid tax from your customer?
_____
yes
_____
no
2
If you answered “yes,” did you unconditionally refund the overpaid tax in full?
_____
yes
_____
no
Please turn page over to complete Parts 4 and 5.
This form is authorized by the Retailers’ Occupation Tax and related tax acts. Disclosure of this information is REQUIRED. Failure to
ST-4-X (R-2/01) front
provide information could result in a penalty. This form has been approved by the Forms Management Center.
IL-492-3210
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